中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2011年
1期
55-59
,共5页
波前像差%切口%角膜%白内障
波前像差%切口%角膜%白內障
파전상차%절구%각막%백내장
Wavefront aberrations%Incision%Cornea%Cataract
目的 比较白内障超声乳化术中透明角膜切口位置对角膜前表面波前像差和散光的影响.方法 前瞻性病例对照研究.选择2007年8月至2008年1月期间因年龄相关性白内障行透明角膜切口白内障超声乳化手术患者46例(62眼),根据透明角膜切口位置的选择分为两组:在最大角膜屈光度子午线方位做透明角膜切口的为试验组,24例(32眼);不论散光轴向在哪个方位均做上方11点方位透明角膜切口的为对照组,22例(30眼).在术前及术后1周、1个月、3个月行医学验光及角膜地形图检查,对视力、散光、像差等数据行重复设计的方差分析.结果 两组患者的最佳矫正视力在术后1周、1个月和3个月3个时间点的比较差异均无统计学意义(P＞0.05).试验组术后l周、1个月和3个月角膜散光量明显小于术前(P＜0.05).试验组术后1周5.0 mm及6.0 mm角膜分析直径的前表面球差与术前相比明显变小(P＜0.05);术后1个月,4.0 mm、5.0 mm及6.0 mm角膜分析直径的前表面总高阶像差、彗差及三叶草像差,5.0 mm及6.0 mm角膜分析直径的前表面球差与术后1周相比明显变大(P＜0.05);术后3个月,4.0 mm、5.0 mm及6.0 mm角膜分析直径的角膜前表面三叶草像差与术后1个月相比明显变小(P＜0.05).在4.0 mm、5.0 mm及6.0 mm角膜分析直径,试验组术后1个月角膜前表面彗差轴向、术后1个月及术后3个月三叶草像差轴向,对照组术后3个月彗差轴向、术后1个月及3个月三叶草像差轴向与术前相比,均明显向角膜切口方位旋转(P＜0.05).结论 按最大角膜屈光度子午线方位做透明角膜切口可以减少角膜散光.早期角膜前表面球差变小,3个月时,各项高阶像差均恢复至术前水平,但彗差和三叶草像差轴向向切口方向旋转.
目的 比較白內障超聲乳化術中透明角膜切口位置對角膜前錶麵波前像差和散光的影響.方法 前瞻性病例對照研究.選擇2007年8月至2008年1月期間因年齡相關性白內障行透明角膜切口白內障超聲乳化手術患者46例(62眼),根據透明角膜切口位置的選擇分為兩組:在最大角膜屈光度子午線方位做透明角膜切口的為試驗組,24例(32眼);不論散光軸嚮在哪箇方位均做上方11點方位透明角膜切口的為對照組,22例(30眼).在術前及術後1週、1箇月、3箇月行醫學驗光及角膜地形圖檢查,對視力、散光、像差等數據行重複設計的方差分析.結果 兩組患者的最佳矯正視力在術後1週、1箇月和3箇月3箇時間點的比較差異均無統計學意義(P＞0.05).試驗組術後l週、1箇月和3箇月角膜散光量明顯小于術前(P＜0.05).試驗組術後1週5.0 mm及6.0 mm角膜分析直徑的前錶麵毬差與術前相比明顯變小(P＜0.05);術後1箇月,4.0 mm、5.0 mm及6.0 mm角膜分析直徑的前錶麵總高階像差、彗差及三葉草像差,5.0 mm及6.0 mm角膜分析直徑的前錶麵毬差與術後1週相比明顯變大(P＜0.05);術後3箇月,4.0 mm、5.0 mm及6.0 mm角膜分析直徑的角膜前錶麵三葉草像差與術後1箇月相比明顯變小(P＜0.05).在4.0 mm、5.0 mm及6.0 mm角膜分析直徑,試驗組術後1箇月角膜前錶麵彗差軸嚮、術後1箇月及術後3箇月三葉草像差軸嚮,對照組術後3箇月彗差軸嚮、術後1箇月及3箇月三葉草像差軸嚮與術前相比,均明顯嚮角膜切口方位鏇轉(P＜0.05).結論 按最大角膜屈光度子午線方位做透明角膜切口可以減少角膜散光.早期角膜前錶麵毬差變小,3箇月時,各項高階像差均恢複至術前水平,但彗差和三葉草像差軸嚮嚮切口方嚮鏇轉.
목적 비교백내장초성유화술중투명각막절구위치대각막전표면파전상차화산광적영향.방법 전첨성병례대조연구.선택2007년8월지2008년1월기간인년령상관성백내장행투명각막절구백내장초성유화수술환자46례(62안),근거투명각막절구위치적선택분위량조:재최대각막굴광도자오선방위주투명각막절구적위시험조,24례(32안);불론산광축향재나개방위균주상방11점방위투명각막절구적위대조조,22례(30안).재술전급술후1주、1개월、3개월행의학험광급각막지형도검사,대시력、산광、상차등수거행중복설계적방차분석.결과 량조환자적최가교정시력재술후1주、1개월화3개월3개시간점적비교차이균무통계학의의(P＞0.05).시험조술후l주、1개월화3개월각막산광량명현소우술전(P＜0.05).시험조술후1주5.0 mm급6.0 mm각막분석직경적전표면구차여술전상비명현변소(P＜0.05);술후1개월,4.0 mm、5.0 mm급6.0 mm각막분석직경적전표면총고계상차、혜차급삼협초상차,5.0 mm급6.0 mm각막분석직경적전표면구차여술후1주상비명현변대(P＜0.05);술후3개월,4.0 mm、5.0 mm급6.0 mm각막분석직경적각막전표면삼협초상차여술후1개월상비명현변소(P＜0.05).재4.0 mm、5.0 mm급6.0 mm각막분석직경,시험조술후1개월각막전표면혜차축향、술후1개월급술후3개월삼협초상차축향,대조조술후3개월혜차축향、술후1개월급3개월삼협초상차축향여술전상비,균명현향각막절구방위선전(P＜0.05).결론 안최대각막굴광도자오선방위주투명각막절구가이감소각막산광.조기각막전표면구차변소,3개월시,각항고계상차균회복지술전수평,단혜차화삼협초상차축향향절구방향선전.
Objective To compare the changes of wavefront aberrations of the corneal anterior surface between different clear corneal incision position (incision on the steepest corneal meridian and incision on the superior position) in phacoemulsification. Methods Forty-six patients (62 eyes) were selected and divided into control group (incision on the superior position, 32 eyes of 24 patients)and test group (incision on the steepest corneal meridian, 30 eyes of 22 patients) according to the position of incision. Examinations of the best corrected visual acuity (BCVA) and corneal topography were carried out before cataract surgery and 1 week, 1 month, 3 months after surgery. Results The differences of BCVA (logMAR) between the two groups before cataract surgery and 1 week, 1 month,3 months after surgery were not significant (P＞0.05). The corneal astigmatism in test group 1 week,1 month and 3 months postoperative were significantly smaller than those of preoperation (P＜0.05).the corneal spherical aberrations (diameter at 5.0 mm and 6.0 mm) in test group 1 week postoperative were significantly smaller than those of preoperations (P＜0.05), the corneal total higher-order wavefront aberrations (HOA) (diameter at 4.0 mm, 5.0 mm and 6.0 mm), coma(diameter at 4.0 mm, 5.0 mm and 6.0 mm), spherical aberrations (diameter at 5.0 mm and 6.0 mm) and trefoil (diameter at 4.0 mm,5.0 mm and 6.0 mm) in test group 1 month postoperative were significantly larger than those of 1 week postoperative (P＜0.05), the corneal trefoil (diameter at 4.0 mm, 5.0 mm and 6.0 mm) in test group 3 months postoperatively were significantly smaller than those of 1 month postoperative (P＜0.05).The axial direction of corneal coma and trefoil in test group and control group 1 month and 3 months postoperative turned to the incision direction obviously. Conclusion The study shows that eyes with incision on the steepest corneal meridian can reduce the corneal astigmatism, and the size and orientation of corneal higher-order wavefront aberrations.
